Parental Compensatory Behaviors and Early Child Health Outcomes in Cebu, Philippines()

A dynamic optimization model of parents choosing investments in their children's health motivates an empirical model of parents' choices of health inputs for their children and the impacts of these decisions on their children's subsequent health. Estimates of the child health input demand functions and the child health production functions from the Cebu Longitudinal Health and Nutrition Survey accord with the prediction that optimizing behavior results in higher levels of aggregate child health. Observable parental behaviors respond to the physical developmental status of their children. These parental responses appear to yield large and statistically significant improvements in children's early physiological outcomes. However, because some health inputs choices are not observable, it is impossible to ascertain whether these measured effects are due solely to variations in the observed input choices.     

Prenatal care and pregnancy outcome in Cebu, Philippines

This paper examines the direct and indirect effects of patterns of prenatal care usage on birth weight and gestational age for a randomly selected sample of 3,080 rural and urban women. We analyze indirect effects of prenatal care on intermediate maternal factors (nutritional, stress, smoking, and drinking), then the impacts of these factors along with prenatal care on pregnancy outcome. The simultaneous equations statistical approach corrects for endogeneity of prenatal care and the intermediate maternal factors. Results of simulations of the effects of changes in the number of prenatal visits on intermediate and health outcome factors have important policy implications.     

A child health production function estimated from longitudinal data. Cebu Study Team

Collaborating researchers used a multi equation model to analyze 3080 mother-infant pairs living on the island of Cebu in the central Philippines and to estimate a child health production function. The econometric methods used eliminated obstacles such as heterogeneity and endogeneity of significant explanatory factors. They also maximized the longitudinal quality of the data. The results showed that morbidity in 1 period reduced infant weight in following periods. For example, diarrhea and febrile respiratory infection reduced growth in the time period following the illnesses. Further effects of some contributing factors were great near birth not diminished with age. For example, breast feeding promoted growth and protected against infection, especially diarrhea and febrile respiratory infection, more substantially near birth than it did later. Further, in urban areas, preventive health care positively affected growth independently of its indirect influence on reducing respiratory infection. Yet it had little effect on diarrhea. Diarrhea had a strong adverse effect on growth. Exposure of the infant to enteric pathogens had the greatest influence on production of diarrhea. In urban areas, exposure included water supply contamination, exposure to feces, a more pathogenic diet, and community crowding. In rural areas, however, exposure included community crowding and increased rainfall which presumably washed feces into the water supply. Household crowding in both urban and rural areas and irritation from smoke in urban areas only tended to bring about febrile respiratory infection.     

The role of child health and economic status in educational, health, and labour market outcomes in young adulthood

Abstract .  The Ontario Child Health Study provides the first opportunity in Canada to assess directly the relationship between socio-economic and health status in childhood and levels of completed schooling, health status, and labour market success in young adulthood. We find that childhood health problems are negatively associated with educational attainment, especially the probability of a university degree, and the health status of young adults. Our results also imply that childhood health problems influence adult labour force outcomes, especially for males, mainly through adult levels of schooling and health.     

Public financing of health expenditures,insurance, and health outcomes

The effects of public financing of health expenditures, insurance coverage and other factors on health outcomes are examined within health production models estimated using 1960–1992 data across 20 OECD countries. Mortality rates are found to depend on the mix of health care expenditures and the type of health insurance coverage. Increases in the publicly financed share of health expenditures are associated with increases in mortality rates. Increases in inpatient and ambulatory insurance coverage are associated with reduced mortality. The effects of GDP, health expenditures and age structure on mortality are similar to those in previous studies. Tobacco use, alcohol use, fat consumption, female labour force participation, and education levels are also significantly related to overall mortality rates. Increases in income inequality are associated with lower mortality rates, suggesting that the negative relationship between inequality and health outcomes suggested by some previous studies does not remain when a more complete model is estimated. The result that increases in public financing increase mortality rates is robust to a number of changes in specifications and samples. Thus, as countries increase the level of their health expenditures, they may want to avoid increasing the proportion of their expenditures that are publicly financed.     

Family income and child outcomes in Canada

Abstract.  A positive relationship between income and child outcomes has been observed in data from numerous countries. A key question concerns the extent to which this association represents a causal relationship as opposed to unobserved heterogeneity. We use data from the National Longitudinal Survey of Children and Youth to implement a series of empirical strategies for estimating the existence and size of the effect of income on three measures of cognition. Our results indicate that the effect of income on these outcomes may well be positive, but that it is likely to be smaller than conventional estimates. JEL Classification: I10     

Family policy,intrahousehold bargaining,and child health

This study examines the effects of an exogenous change in family policy in Ethiopia on women empowerment and the allocation of resources toward child health. Empowerment is formalized as an unobserved latent variable based on a large set of questions pertaining to women's autonomy and decision-making power. Exploiting the time and regional variation in the implementation of the law, the study finds that early implementation of the reform increases women's access to information, literacy and education levels, and their assertiveness toward family planning and domestic violence. In addition, more decision power in the hands of women is found to have a positive impact on investments in the health and nutrition of children. The findings suggest that factors that do not enter the individual's preferences may affect outcomes for individuals and emphasize the role of intrahousehold heterogeneity. The results are robust to a battery of validity and specification checks.     

Non-cognitive child outcomes and universal high quality child care

Exploiting a rich panel data child survey merged with administrative records along with a pseudo-experiment generating variation in the take-up of preschool across municipalities, we provide evidence of the effects on non-cognitive child outcomes of participating in large scale publicly provided universal preschool programs and family day care vis-à-vis home care. We find that, compared to home care, being enrolled in preschool at age three does not lead to significant differences in child outcomes at age seven no matter the gender or the mother's level of education. Family day care, on the other hand, seems to significantly deteriorate outcomes for boys whose mothers have a lower level of education. Finally, longer hours in non-parental care lead to poorer child outcomes.     

Determinants of child mortality,health, and nutrition in a developing country

The authors investigate the determinants of child mortality and health and nutrition status in Nicaragua using economic models of household behavior. In particular, they examine regional differences by degree of urbanization. Various factors affecting child mortality are considered. The results indicate that "income is not an important factor, there is an inverse relation with number of siblings, and there are positive associations with calorie intake, schooling (except in the relatively low-income areas), the availability of refrigeration, and the quality of sewage systems."     

Home care reimbursement,long-term care utilization,and health outcomes

Using a substantial change in Medicare reimbursement policy to study the market for home health care, I find that the introduction of tightly binding average per-patient reimbursement caps led to a large drop in the provision of home care, particularly to the least healthy beneficiaries. This decline in home health utilization was not offset by increases in institutional long-term care or other medical care and there were no associated adverse health consequences. However, approximately one-quarter of the decline in Medicare spending was offset by increases in out-of-pocket expenditures for home health care, with the offset concentrated in higher income populations.     

The determinants of child mortality in the Philippines: estimation of a structural model

"This paper employs a longitudinal data set from the Philippines to estimate a structural model of the determinants of infant mortality. To control for the endogeneity of some explanatory variables, a set of reduced form equations for these outcomes is estimated simultaneously with the mortality hazard. A non-parametric discrete factor method is used to control for common unobservable factors in the error terms. Birth interval and parity lose explanatory power once biological measures are considered in the model. The results indicate significant correlations across the equations' error terms. The significant effects of breastfeeding and growth on mortality are quantified in simulation experiments." The data are from a longitudinal survey conducted in metropolitan Cebu between 1983 and 1986.     

Effect of public programs on family size,child education and health

"A bulk of public resources in developing countries is devoted to the subvention of population control and health investments. The effects of these programs have been evaluated in this study with household and community data from Bangladesh. The results suggest that subsidy on family planning and secondary school would be most effective in the achievement of harmonious goals of reducing fertility and mortality and fostering investments in child education."     

Convergence in per capita health expenditures and health outcomes in the OECD countries

Our analysis of 19 Organization for Economic Co-operation and Development (OECD) countries over the period 1972 to 2006 provides evidence of convergence in per capita health care expenditures for 17 countries, while the US and (to a lesser degree) Norway follow a different path. A simple decomposition of per capita health expenditures reveals that the divergence of the US comes from the divergence of the ‘ratio of health care expenditures to Gross Domestic Product (GDP)’ component, while Norway's divergence is mainly caused by the ‘labour productivity’ component. Interestingly, our results suggest that convergence in per capita health expenditures among the 17 OECD countries does not lead to convergence in health outcomes. Finally, we extend our analysis to examine convergence in various determinants of health expenditures.     

Dirty hands on troubled waters: Sanitation,access to water and child health in Ethiopia

In this paper, we investigate the impact of access to drinking water sources and sanitation facilities on the incidence of diarrheal diseases among children below 5 years of age in Ethiopia using the propensity score matching technique with a polychotomous treatment variable. We find that among the water sources traditionally considered as improved, only water piped into dwelling, yard or plot leads to a large percentage point reduction in diarrhea incidence. The other water sources, generally believed as clean, are not effective in reducing diarrhea even compared with some of the unimproved water sources. We also find that some unimproved water sources and sanitation facilities are less inferior than they are believed to be. These results suggest that the traditional way of categorizing different types of improved and unimproved water sources and sanitation facilities into a dichotomous variable, “improved” or “unimproved”, could be misleading as it masks the heterogeneous effects of the water sources and the sanitation facilities.     

多元化战略、母子公司管控与企业绩效

多元化经营能帮助企业实现协同效应,进而提升企业绩效,但已有的实证研究大多得到与此相反的结果。通过问卷调查获取87家集团公司下属子公司的经营数据,检验企业多元化与母子公司管控(包括管控程度和管控方式)对企业绩效的交互效应。研究发现:实施多元化战略的公司对子公司采取正式管控会降低企业整体绩效;但母子公司管控程度与多元化经营的交互效应不显著。     

The health consequences of hazardous and nonhazardous child labor

The health consequences of child labor are ambiguous. On the one hand, heavy lifting, using dangerous tools and handling fertilizers may impact negatively on health. On the other, child labor could be used to achieve a minimal subsistence standard, without which the child could experience deteriorating health. Previous empirical studies are inconclusive because, until now, existing data sources could not disentangle between different activities performed by child workers. To establish how work is related to health, it is essential to know what activities are being performed. This study fills this gap with a unique child labor survey conducted in Peru in 2015. Child labor is classified into hazardous and nonhazardous activities. The econometric results suggest that children doing nonhazardous work are less likely to have health problems than nonworking children. Conversely, those that work in hazardous activities are potentially more likely to exhibit health concerns. A series of robustness tests confirm these findings. The results give impetus to the notion that child work increases total resources available for households, which can improve child health. Therefore, it is over and above this potential increment in resources that some hazardous activities worsen working children's health.     

Youth Poverty,Employment, and Leaving the Parental Home in Europe

This paper studies the nature of youth poverty dynamics in Europe. First, it analyzes to what extent experiencing poverty in a given period is in itself positively related to the probability of living below the poverty line again in the future. That is, we assess the degree of poverty genuine state dependence among young people. Second, we study the interrelationships between poverty, employment, and residential emancipation. The results show that youth poverty genuine state dependence is positive and highly significant, but this scarring effect is short‐lived in Scandinavia compared to Southern or Continental Europe. Moreover, although we find a strong association between poverty and leaving home in Nordic countries, time spent in economic hardship does not last long. On the contrary, in Spain and Italy, young adults tend to leave their parental home much later in order to avoid falling into a poverty state that is more persistent.     

The effects of health aid on child health promotion in developing countries: cross-country evidence

Although epidemiological knowledge in relation to child health has improved in the last few decades, around 3 million children die each year in developing countries from preventable diseases. The international development community views increased immunization coverage for children as an important step in eliminating or reducing these deaths. Many developing countries have very limited resources to tackle major health problems and have to rely on external finance. This article examines the impact of foreign aid devoted to the health sector on child health promotion in developing countries. Two proxies for child health promotion are used: (a) immunization against measles and (b) immunization against Diphtheria–Pertussis–Tetanus (DPT). A range of model specifications and panel data econometric techniques are applied to data covering the period 1990 to 2005. This article finds a positive and statistically significant link between health aid and the measures of child health promotion.     

Parental preferences,production technologies,and provision for progeny

This paper theoretically explores the implications of the recent developments in the study of human capital production technologies (Cunha and Heckman, 2007) in intrahousehold human capital investment in children (Becker and Tomes, 1976; Behrman et al., 1982). When credit constraints are not binding, parents adopt a reinforcing intrahousehold investment strategy. When credit constraints are binding, the trade-off between the degree of parental aversion to inequality and the degree of complementarity between pre-natal endowments and family investments determines the parental strategy. The observed investment pattern of reinforcement or compensation does not necessarily reveal the underlying preference or technological parameters. Finally, we discuss empirical methods that may separately identify the preference and technological parameters and discuss the econometric challenges associated with these methods.